Adderall Addiction in Singers: Medicinal Madness
Amber was a 23-year old recent college graduate with a BFA Degree in Musical Theater. She studied singing with me the summer she was 20: She had a great sense of humor and was also an accomplished dancer. Her college voice training seemed to be working for her at that point. We had a fun together working on repertoire for her audition book, as well as continuing her technical and expressive development. I did not hear from her again until….
…. right after she graduated from college. When she contacted me she said that there was something “terribly wrong” with her voice. Her teacher and others she had consulted were not able to help. She wrote that she had seen an otolaryngologist recommended by the college voice program, and he had determined that her vocal cords and surrounding muscles were fine. We arranged for a consult and I asked her to bring a copy of her doctor’s report.
When she arrived I couldn’t believe that it was the same young woman I had met several years before. Her demeanor was drastically changed, her face sunken and anxious. When she sang, her breath response was completely locked up and her once-lively tone had become a thin wisp or a yelled-throaty-strangle. She stood stiffly and was not engaged in any way.
What, on earth, had happened in the several years since I had seen her? She was with the same teacher all four years.
It would have been a complete waste of time to work on “breathing.” Since I had worked with her before, my first thoughts were 1) substance abuse or 2) medical side effects. It turned out to be both, through no fault of her own.
WHERE TO START….
In our consult lesson I asked what had changed in her life since I saw her last. She told me she had broken up with her boyfriend and was diagnosed with ADD and severe anxiety disorder. DING! I asked her if she was taking medication for ADD and she said she was on Adderall. DA-DING! I asked how long she had been on it and she said over 2 years. My jaw dropped. DA-DOOONG. Here is why this is significant—
Any medication not prescribed or used properly can lead to trauma or death, but Adderal addiction has become prevalent in sports, the military and for anyone trying to “keep pace” in overextended activities in our fast-paced lives. Addiction can lead to severe psychosis, paranoia, respiratory distress, dry mouth, irritability, anxiety, muscle stiffness and insomnia. It is very hard on the central nervous system. I told her that it was my understanding that Adderall is sometimes used at the beginning of treatment for ADD, or ADHD and then a less toxic drug is prescribed for consistent use.
It turns out that her psychiatrist, in the town where she went to college, was regularly refilling her Adderall prescription WITHOUT monitoring her. It’s common for people who are addicted to be able to outsmart their doctors. They can present as “normal” and well-spoken and regularly convince doctors to keep refilling their prescriptions without reevaluation or willingness to wean off the drug wisely.
I told Amber that I thought that the medication was causing massive central nervous system dysfunction. At this point she said that she couldn’t dance for more than a few minutes without becoming winded and exhausted. She also said that my theory was the first sane speculation she had heard as to why her voice had stopped working.
After beginning to cry, she said that her relationship with her parents was strained because they were tired of seeing her so strung out and unhappy. They also had said they would not support her at all financially (including living at home) past the summer after she graduated.
But more importantly, she was willing to try to end her addiction. This is key. Teachers are constantly treading the fine line between understanding their limits and guiding students towards ways to improve cognitive function and health.
SO I CAME UP WITH A PLAN
1. I wrote an email to her parents, explaining what I felt was the problem and suggesting ways they might help her. I never heard back from either of them, although they were paying for her lessons that summer after her graduation. They were furious with her for needing lessons after they had paid for college to learn “this stuff.”
2. So I guided her towards finding a psychiatrist on her insurance plan who could wean her off the narcotic and help her transition to another ADD drug. I told her that she absolutely had to be in therapy during this transition.
3. I suggested that we wait two-three weeks from the time she started with her new doctor to meet again.
4. I had a five minute phone call with her once during those weeks. When she came back two weeks later, the sparkle was back in her eyes, she was able to laugh more easily, breath response was more active and she felt her voice coming back. She clearly liked her new doctor and trusted her.
Setting my own personal boundaries was SO MUCH part of this process.
SO THEN WHAT HAPPENED?
Amber and I then had 6 sessions together to start to unwind compensatory vocal behaviors and retrain her physical/mental coordination. We also used movement exploration and simple activities from Chekov Psychological Gesture Work to connect her back into her body. (Thank you to Dr. Matt Edwards for introducing me to this kind of work through his blog post.)
I told her that we would work repertoire as soon as possible, but she suddenly stopped coming for sessions. Her former teacher sent me a link to her senior recital, where I felt Amber was clearly just holding on for dear life to get through her final program requirement. The link was accompanied by a note from her teacher, boasting that the recital was proof that Amber had the full package and was fully marketable. The teacher didn’t seem to notice how much trouble that young woman was in, although she did thank me for “helping her figure out what was wrong with her throat muscles.”
Uh, okay?
Perhaps the college teacher couldn’t admit she missed the boat with Amber or just needed to focus on the only thing she felt she could do to get her through her degree. (In a future post, I’ll describe a time I completely missed the boat, and what I did about it.)
Making large mistakes happens–it is part of the experience of being human. We are in a field where a lifetime is not long enough to learn what we need to know.
The key is, how do you learn from the experience and take responsibility? How do you reevaluate what you thought you were doing to help? There is no shame in that.
The last I heard, Amber had gone to New York City and was making the audition rounds while continuing to study with her college teacher. I would be very surprised if she got hired for anything, but I have to accept that maybe my role in this singer’s life was just to help get her off a drug that was destroying her.
Update: Amber spent several years trying to earn a living as an artist/educator. Then she wrote to me again and asked if I’d provide a reference for her to go back to school for a graduate music therapy program, and to recommend a good guitar teacher for her.
Out of the ashes rises the phoenix! I think Amber found her path.
For more reading:
Drowned in a Sea of Prescriptions
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